Agenda and minutes

There were no Declarations of Interest made at the meeting.

There were no members of the public or press present at the meeting.

Consideration was given to the minutes of the previous meeting of the Health Select Commission held on 18^th October, 2018.

Resolved:-  That the minutes of the previous meeting held on 18^th October, 2018, be approved as a correct record.

Arising from Minute No. 40 (TRFT Quality Priorities 2019-20), it was noted that a collated response from the Select Commission had been sent to the Trust after Members had received the additional information and prioritised the long list.  Overall the 5 priorities under clinical effectiveness had been emphasised the most particularly the Dementia Unit.  The Quality Sub-Group would be able to ask further questions on the priorities when it met in January.

Arising from Minute No. 41 (Visit to Carnson House), it was noted that the visit was to be rescheduled as it had coincided with a CQC inspection.

Arising from Minute No. 42 (Child and Adolescent Mental Health Services Update), it was noted that the outcome of the Trailblazer bid was not known as yet.

Improving Lives Select Commission

Councillor Jarvis gave a brief summary of the agenda items considered at the last meeting of the Improving Lives Select Commission as follows:-

-          Increased numbers of Looked After Children

Possible reasons for the increase

Initiatives coming into place to counteract the numbers

Increased management oversight

Right Child Right Care

Edge of Care Panel

Foster parent recruitment

63 Initiative

-          Education Performance Outcomes

Actions more aspirational rather than targets, so officers had been asked to come back with something sharper

Visits

Councillor Williams gave a verbal report on the visit to the Health Village, Doncaster Gate, Care Co-ordination Centre, Rotherham Hospital and the Adult Care Single Point of Access that had taken place on 13^th November, 2018.

It was quite clear that all 3 teams had a passion/dedication for the role they were undertaking and the work they were providing.  Clear benefits from having people from different teams together, included quick immediate help and advice and developing people’s awareness and there was clear belief in this approach and that it was making a difference.

-       Sharon Kemp, Chief Executive and partners to present

Sharon Kemp, Chief Executive, Chris Edwards, Rotherham Clinical Commissioning Group and Louise Barnett, The Rotherham Foundation Trust, gave the following short powerpoint presentation on Rotherham Integrated Care Partnership (Rotherham ICP) and the implementation of the Rotherham Integrated Health and Social Care Place Plan (IH&SC):-

Rotherham ICP Partners

-          NHS Rotherham Clinical Commissioning Group

-          Rotherham Metropolitan Borough Council

-          The Rotherham NHS Foundation Trust

-          Rotherham Doncaster and South Humber NHS Foundation Trust

-          Voluntary Action Rotherham

-          Connect Healthcare Rotherham CICI

Rotherham ICP Place Governance

-          Rotherham Together Partnership

-          Rotherham Health and Wellbeing Board

-          Rotherham ICP Place Board

-          Rotherham ICP Delivery Team – Children and Young People, urgent Care, Community, Learning Disability, Mental Health

Rotherham ICP Place Plan: ‘Plan on a Page’

-          Vision

-          Gaps

-          Challenges

-          Transformation

-          Enablers

-          Principles

-          Partners

Rotherham ICP Place Plan Priorities

-          Children and Young People

Implementation of Children and Young Peoples Mental Health Services Transformation Plan

Maternity and Better Birth

Oversee delivery of the 0-19 health child pathway services

Children’s Acute and Community Integration

Special Educational Needs and Disability (SEND) – Journey to Excellence

Implement ‘Signs of Safety’ for Children and Young People across partner organisations

Preparing for Adulthood (Transitions)

-          Mental Health and Learning Disability

Deliver improved outcomes and performance in the Improving Access to Psychological Therapies Service

Improve Dementia diagnosis and support

Deliver CORE 24 standards for Mental Health Liaison Services

Transform he service at Woodlands ‘Ferns’ Ward

Improve Community Crisis Response and intervention for Mental Health

Better Mental Health for All Strategy

Oversee Delivery of Learning Disability Transforming Care

Support the implementation of the ‘My Front Door’ Learning Disability Strategy

Support the development and delivery of Autism Strategy

-          Urgent and Community

Creation of an Integrated Point of Contact for Rotherham

Expansion of the Integrated Rapid Response Service

Development of an integrated Health and Social Care Team to support the discharge of people out of hospital

Implementation of integrated locality model across Rotherham

Develop a reablement and Intermediate Care offer

Develop a co-ordinated approach to care home support

Key Achievements

-          Urgent and Emergency Centre

Opened July 2017 delivering an innovative integrated model to improve co-ordination and delivery of urgent care provision

-          Rotherham Health Record

Enables health and care workers to access patient information to make clinical decisions

-          Delayed Transfers of Care

Successful reduction in Delayed Transfer of Care to below national target

Supported by the integration of TRFT Transfer of Care Team and RMBC Hospital Social Work Team to form the Integrated Discharge Team

-          Ferns Ward

Provides integrated specialist mental and physical health care expertise for TRFT patients who are physically well enough to be discharged from the acute setting but are not yet well enough to be discharged home or to residential care

-          Social Prescribing

Continued success, helping adults over the age of 18 with long term health conditions to improve their health and wellbeing by helping them to access community activities  ...  view the full minutes text for item 53.

-               Lucy Harrison, CGL, Anne Charlesworth, RMBC and partners to present

Lucy Harrison, CGL, and Anne Charlesworth, RMBC, Matt Pollard, RDaSH, gave the following powerpoint presentation:-

Successful Opiate completions

Defined by Public Health England as:-

-          Drug free, alcohol free or occasional user (not opiate/crack) discharges in the previous 12 months as a proportion of all clients in treatment in that period (latest treatment journey used)

Representations defined by Public England as:-

-          All drug free, alcohol free and occasional user (not opiate/crack) discharges 6-12 months ago who have re-presented within 6 months as a proportion of all drug free, alcohol free and occasional user (not) discharges 6-12 months ago (latest treatment journey used)

Rotherham’s Performance

Since April 2018 – contract commencement

Our Approach: Evidence based optimised prescribing

-          Staff training and education events – using data and service information

-          Medication dose review for all Service users – highlighting those on 30 ml Methadone or less daily or 6 mg Buprenorphine or less daily and not using illicitly on top

-          Reduction and detox options discussed with Service users

-          A number of models of detox and reduction – Service user lead and clinically  safe – our primary detox offer is a 2 week front loaded Buprenorphine detox with intensive wraparound PSI and clinical support – detox takes 12 weeks from commencement to completion

-          Engagement with Shared Care Practices – same offer with GPs offering the detox or a reduction (less than 12 weeks) this is supported by the Shared Care Worker in the practice

-          A clear offer for sustained recovery through Foundations of Recovery and support from peer mentors, Mutual Aid and the recovery service

Our Target

-          To continue to support Service users through a range of clinical and psycho-social interventions aimed at supporting individuals to successfully exit patterns of addiction and ongoing prescribing into sustained and positive recovery and abstinence from opiates and medication

-          To deliver on Rotherham’s ambition to pull the rate of recovery from opiate dependence up to that in comparable areas of England – 1.5% year on year is the improvement needed to do this but starting from a challenging position

Discussion ensued with the following issues raised/clarified:-

·           CGL had found that some of the users were on an suboptimal dose i.e. they were on a dose of Methadone of 50-45 ml which meant that they were buying Heroin illicitly on top of their Methadone prescription.  This stopped them from engaging in treatment, they may be committing crimes and it was quite unsafe and could actually contribute to the risk of drug related death.  Those Service users were not detox or reduction ready because they were still using opiates illicitly on top of a prescription so their Methadone dose had been increased.  There was a clinical intervention where their use on top of their prescription was discussed, review their dose and look  ...  view the full minutes text for item 54.

Janet Spurling, Scrutiny Officer, presented an update on the Select Commission’s work programme for 2018-19 providing options for potential spotlight reviews and for the work of the Performance Sub-Group.

Discussion included:-

Select Commission/Spotlight Reviews

Further update on RDaSH Estate Strategy

Enablement/Reablement

Transition from Children’s to Adult Social Care Services – joint work with Improving Lives Select commission

Local Maternity Plan

Potential Service changes at Rotherham Community Health Centre on Greasbrough Road

Implementation and impact of Service Changes

Changes to Intermediate Care and Learning Disability Services

Performance Sub-Group

Joint Outcomes Framework for Locality Working

Urgent and Emergency Care Centre measures

Rotherham Integrated Health and Care Place Plan measures - Quarter 2 Scorecard

Implementation and impact of Service Changes

Following from the issues raised earlier in the meeting around primary care, reference was made to the previous scrutiny review that had looked at Access to GPs and the information provided for the meeting in March 2018.  Localised data sets including disaggregation by equality protected characteristics would be useful and more information about how the appointments in the three hubs are communicated to patients.

Members suggested other potential items for the work programme - data around suicides and suicide prevention work and autism provision for primary aged children, including possible visits to other local authorities including Sheffield.

Resolved:-  (1)  That the report be noted.

(2)  That the link to the National Survey of Patients be circulated to Select Commission Members.

(3)  That the summary of the previous Scrutiny Review of GPs be circulated to Members.

(4)  That Members send Key Lines of Enquiry regarding General Practice to Janet Spurling, Scrutiny Officer, in preparation of the February meeting.

No issues had been raised.

Resolved:-  That the Chair extend an invitation to Tony Clabby, Chair, Healthwatch Rotherham, to attend the meeting.

The Chair gave an update for the South Yorkshire, Derbyshire, Nottinghamshire and Wakefield Joint Health Overview and Scrutiny Committee by confirming:- 

-          JHOSC had met in October the agenda for which had included the SY&B ICS and the next steps in response to the Hospital Services Review recommendations through a strategic outline business case

-          Members had emphasised the importance of public engagement and improving communication

-          Assurance had been sought that the plans would be delivered within resources and that they would address health inequalities and the variations in performance between hospitals

-          Further information was required and provided after the meeting and could be shared with the Select Commission i.e.

Progress update on changes to Hyper Acute Stroke and non-specialised Children’s Surgery and Anaesthesia

Communications and engagement plan

More information with regard to the workforce issues raised in the Hospital Services Review

-          The next meeting would be held in January/February 2019

In relation to the South Yorkshire and Bassetlaw Integrated Care System the cover report had stated that “Integrated care system leaders gain greater freedoms to manage the operational and financial performance of services in their area”.

Clarification had been sought as to what was meant by “greater freedoms”.

From the Memorandum of Understanding agreed nationally this meant that local systems that were working well had greater freedom in how they ensured extra funding and support got to where it was needed in local communities.

Resolved:-  That the information be noted.

Consideration was given to the submitted minutes of the Health and Wellbeing Board held on 19^th September, 2018.

Resolved:-  That the minutes of the Health and Wellbeing Board held on 19^th September, 2018, be noted.

Thursday, 17^th January, 2019, commencing at 10.00 a.m.

Resolved:-  That a further meeting be held on Thursday, 17^th January, 2019, commencing at 10.00 a.m.